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LIFE MEDICAL, P.A.
NPI 1740222496
Clinic/Center - Multi-Specialty in Saint Louis Park, MN

Active since June 10, 2006CLIA 24D1062275 · Waiver
4201 EXCELSIOR BLVD, SAINT LOUIS PARK, MN 55416(952) 933-1121(952) 945-9536 Get Directions Write a Review

NPPES record last updated: September 18, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 18, 2025, Nov 30, 2022, Feb 28, 2018 (3 updates tracked since 2018).

About Life Medical, P.a. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIFE MEDICAL, P.A. (NPI 1740222496), doing business as Life Medical, is a healthcare organization registered as a multi-specialty in Saint Louis Park, Minnesota and active in the NPI registry since June 2006. The organization holds a CLIA Waiver certificate valid through December 10, 2026 and lists Jacob I Mirman, Managing Partner, as its authorized official.

NPPES Registry Identity

NPI1740222496
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameLIFE MEDICAL, P.A.
Location Address4201 EXCELSIOR BLVDSaint Louis Park, MN 55416-4728
Mailing Address4201 Excelsior BlvdSaint Louis Park, MN 55416-4728 · (952) 933-8900 · Fax (952) 945-9536
Phone(952) 933-1121
Fax(952) 945-9536
Organization SubpartNo
Authorized OfficialJacob I MirmanManaging Partner · (952) 933-8900
Enumeration DateJune 10, 2006
Last NPPES UpdateSeptember 18, 20253 updates tracked since enumeration
NPPES CertifiedSeptember 18, 2025
✔ NPI 1740222496 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
4201 EXCELSIOR BLVD, Saint Louis Park, MN 55416
Open in Google Maps ↗

Other Names 1

Doing Business AsLife Medical

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners, Medica.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 24D1062275

Life Medical, PA · Saint Louis Park, MN
Active · expires Dec 10, 2026
CLIA Number24D1062275
Laboratory TypePhysician Office
Certificate Effective DateDecember 11, 2024
Certificate Expiration DateDecember 10, 2026
Laboratory DirectorJacob I. Mirman
Laboratory Phone(952) 564-3880
Laboratory LocationLife Medical, PA4201 Excelsior Blvd, Saint Louis Park, MN 55416
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RACHEL ANDERSON NP-C
Nurse Practitioner
4201 EXCELSIOR BLVD
ST LOUIS PARK, MN 55416
Hennepin County (952) 933-8900
DR. JILL MAVEN GRAY PSYD, LP
Psychologist (Clinical)
4201 EXCELSIOR BLVD
ST LOUIS PARK, MN 55416
Hennepin County (952) 933-8900
DR. TOAN QUOC TRAN D.P.T.
Physical Therapist
4201 EXCELSIOR BLVD
SAINT LOUIS PARK, MN 55416
Hennepin County (952) 933-8900
MINNESOTA MEDICAL AND REHABILITATIVE SERVICES, LLC
Physical Therapist
4201 EXCELSIOR BLVD
ST. LOUIS PARK, MN 55416
Hennepin County (952) 564-3880
DR. OLGA KARACHENETS M.D.
Family Medicine
4201 EXCELSIOR BLVD
ST LOUIS PARK, MN 55416
Hennepin County (952) 933-8900
LINDA SHAW HALLER PA-C, MPH
Physician Assistant (Medical)
4201 EXCELSIOR BLVD
ST LOUIS PARK, MN 55416
Hennepin County (952) 564-3880
HOMEOPATHIC MEDICAL CLINIC
Clinic/Center (Health Service)
4201 EXCELSIOR BLVD
MINNEAPOLIS, MN 55416
Hennepin County (952) 933-8900
TARAN JOHN BARRETT DC
Chiropractor
4201 EXCELSIOR BLVD
ST LOUIS PARK, MN 55416
Hennepin County (952) 933-8900

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Life Medical, P.A.'s NPI number?

The NPI number for Life Medical, P.A. is 1740222496. It was assigned to this organization in the NPPES registry on June 10, 2006. The provider is doing business as Life Medical.

Where is Life Medical, P.A. located?

Life Medical, P.A. is located at 4201 Excelsior Blvd, Saint Louis Park, MN 55416. The listed phone number is (952) 933-1121.

What is Life Medical, P.A.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Does Life Medical, P.A. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D1062275) is associated with this NPI, valid through December 10, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Life Medical, P.A. accept?

Health plans from HealthPartners and Medica list Life Medical, P.A. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Life Medical, P.A. was last updated on September 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.